Valsartan + Hydrochlorothiazide

Indications

Valsartan + Hydrochlorothiazide is used for: Hypertension

Adult Dose

Oral Hypertension Adult: 1 tablet/day (80-160 mg valsartan/12.5-25 mg hydrochlorothiazide); may be titrated after 1-2 weeks of therapy; not to exceed 320 mg valsartan/25 mg hydrochlorothiazide daily

Child Dose

Renal Dose

Administration

Contra Indications

Hypersensitivity to valsartan, hydrochlorothiazide or sulphonamides. Severe hepatic impairment, creatinine clearance <30ml/min, anuria, cirrhosis, biliary obstruction, conditions where there is increased potassium loss (e.g. salt losing nephropathies and pre-renal impairment of kidney function), refractory hypokalaemia, hyponatraemia, hypercalcaemia, hyperuricaemia, history of gout and uric acid stones, untreated Addison's disease. Pregnancy and lactation.

Precautions

DM, postsympathectomy patients. May exacerbate SLE. Monitor serum potassium regularly. Observe for signs of fluid or electrolyte imbalance. Discontinue before testing for parathyroid function. May affect ability to drive or operate machinery. Elderly. Lactation: Discontinue drug, or do not nurse

Pregnancy-Lactation

Pregnancy category: 1st trimester, C; 2nd and 3rd trimesters, D

Interactions

Valsartan: May antagonise hypotensive effects and increase the risk of renal impairment w/ NSAIDs. Increased risk of hyperkalaemia w/ K-sparing diuretics, K supplements or K-containing salt substitutes. Potentially Fatal: Increased risk of hypotension, hyperkalemia and changes in renal function (including acute renal failure) when used w/ aliskiren in patients w/ diabetes and renal impairment (GFR <60 mL/min). Hydrochlorothiazide: Increases toxicity of lithium. May potentiate orthostatic hypotension w/ barbiturates and narcotics. Enhanced neuromuscular blocking action of competitive neuromuscular blockers (e.g. atracurium). Increased hypokalaemic effect w/ corticosteroids, corticotropin, ?2 agonists (e.g. salbutamol). Additive effect w/ other antihypertensives. Potentiation of orthostatic hypotension w/ barbiturates or opioids. Reduced antihypertensive effect by drugs that cause fluid retention (e.g. corticosteroids, NSAIDs, carbenoxolone). Enhanced nephrotoxicity of NSAIDs. Reduced therapeutic effect of antidiabetics.

Adverse Effects

Side effects of Valsartan + Hydrochlorothiazide : 1-10% Valsartan Hyperkalemia (4-10%),Dizziness (2-8%),Hypotension (1-7%),Fatigue (3%) Frequency Not Defined Hydrochlorothiazide,Anaphylaxis,Anemia,Anorexia,Confusion,Dizziness,Epigastric distress,Erythema multiforme,Exfoliative dermatitis, including toxic epidermal necrolysis,Headache,Hyperuricemia,Hypokalemia or hypomagnesemia,Orthostatic hypotension,Photosensitivity,Stevens-Johnson syndrome

Mechanism of Action

Valsartan is an angiotensin II receptor antagonist and reduces blood pressure by blocking the vasoconstrictive and aldosterone-secreting effects of angiotensin II. Hydrochlorothiazide is a thiazide diuretic.